PCDH is a health data exchange system with a focus on interstate exchange. The notification and exchange system synchronizes patient health records across several participating health information exchanges (HIEs) to allow patients to alert their providers when they have a physician interaction or health event across state lines.

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Seventeen HIEs previously worked together to prove the concept for the notification and HIE network. Following these successful efforts, all participating HIEs signed on to a common, national agreement to connect regional implementations. The three regional implementations of PCDH included a western, heartland, and central implementation. Each implementation required that participants coordinate with multiple interstate HIEs.

“The HIEs working together to create PCDH built a powerful foundation for interoperability between HIEs — and we managed to do it using our current technologies. We’re very proud of this accomplishment and the milestone we’ve achieved,” said Executive Director of HEALTHeLINK and SHIEC Board of Directors Chair Dan Porreca. “We also created and agreed to a national, legally-binding agreement, which laid the foundation for HIEs sharing data with each other across state lines and throughout communities.”

All participating HIEs work together as part of the initiative to enable the technical functionality to automatically retrieve patient health records across state lines and notify providers about interstate treatment episodes a patient may have.

“Through PCDH, not only do we receive data for patients living in this area who are treated elsewhere while traveling, we are now able to notify other HIEs when their patients are treated here,” said East Tennessee Health Information Network (eTHIN) Executive Director Leigh Sterling. “etHIN’s region contains the most visited national park in the country. Because visitors to our area often seek medical attention while they are here, we have medical data on patients living in all 50 states.”

To notify providers that a patient has arrived at a facility away from home, receiving facilities generate an admission, discharge and transfer (ADT) message including patient demographic information. Using the ZIP code contained within the ADT message, PCDH alerts the HIE in the patient’s home region about the encounter. Next, the home HIE allows the receiving facility to generate a query for the patient’s EHR.

When the treatment encounter is over, the treating facility’s HIE can alert the patient’s home HIE of any new health data. New health data can be integrated into the patient’s comprehensive medical history.

“We have always been a proponent for greater interoperability, and quickly recognized that PCDH would provide us with the ability to expand interoperability beyond our borders,” said Utah Health Information Network (UHIN) President and CEO Teresa Rivera.

“As a frontier state, for many Utahns the nearest hospital may be in a neighboring state,” she continued. “Equally as important, there are thousands of patients from outside Utah who seek medical treatment at the region’s leading burn clinic, children’s hospital and cancer center all of which are located in Salt Lake City.”

UHIN and other HIEs that participated in the development and testing of the PCDH project have improved care coordination, patient health outcomes, and clinical efficiencies since implementing the initiative.

All three regional HIE networks are now connected to form a nationwide system capable of securely sharing patient health data.